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Surgical Endoscopy

, Volume 26, Issue 10, pp 2729–2734 | Cite as

Single-incision versus conventional laparoscopic colectomy for colonic neoplasm: a randomized, controlled trial

  • Jensen T. C. Poon
  • Chi-Wai Cheung
  • Joe K. M. Fan
  • Oswen S. H. Lo
  • Wai-Lun Law
Article

Abstract

Background

Single-incision laparoscopic colectomy (SILC) is a newly developed procedure with the benefit of better cosmetic outcome and potentially reduced wound pain compared with conventionally laparoscopic colectomy (CLC). However, the application of SILC requires careful evaluation to prove its benefit and safety. This randomized, controlled study compared the operative outcome of patients who underwent SILC and CLC.

Methods

Patients who had small cancer (<4 cm) or adenomatous polyp requiring colectomy were randomized to have SILC or CLC. The patients were blinded to the procedures and the postoperative pain was used as the primary outcome measure. All patients had patient-controlled analgesia with intravenous morphine after the operation and the nominal rating score on days 1–3 and day 14 were recorded by research staff, who did not known the types of operations. Other operative outcomes of the two groups of patients also were recorded prospectively and compared.

Results

There were 25 patients in each group. The patients’ demographics, tumor characteristics, operating time, blood loss, complication rate, number of lymph nodes harvested, and resection margin have no statistically significant difference between the two groups. There was no operative mortality in both groups. The SILC group had consistently lower median pain score than CLC group in the whole postoperative course and the difference was statistically significant on day 1 (0 (0–5) vs. day 3 (0–6) respectively; p = 0.002) and day 2 (0 (0–3) vs. 2 (0–8) respectively; p = 0.014). The median hospital stay in the SILC group also was shorter the CLC group.

Conclusions

In a selected group of patients with small tumor and good operative risk, SILC is a safe alternative to CLC. Single-port laparoscopic colectomy also is associated with the benefits of less postoperative pain and shorter hospital stay than CLC.

Keywords

Colorectal Cancer 

Notes

Disclosures

Dr. Poon, Dr. Cheung, Dr. Fan, Dr. Lo, and Professor Law have no conflict of interest or financial ties to disclose.

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Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  • Jensen T. C. Poon
    • 1
  • Chi-Wai Cheung
    • 2
  • Joe K. M. Fan
    • 1
  • Oswen S. H. Lo
    • 1
  • Wai-Lun Law
    • 1
  1. 1.Division of Colorectal Surgery, Department of SurgeryQueen Mary Hospital, The University of Hong KongHong KongHong Kong
  2. 2.Department of AnesthesiologyQueen Mary Hospital, The University of Hong KongHong KongHong Kong

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